Pharmacist-led medication management program within a patient-centered medical home

• Published in: American journal of health-system pharmacy 2015-03, Vol.72 (6), p.453-459
• Main Authors: ROMANELLI, ROBERT J, LEAHY, ANGELA, JUKES, TREVOR, ISHISAKA, DENIS Y
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Ambulatory Care - organization & administration; Drug therapy; Emergency Service, Hospital - statistics & numerical data; Female; Home care; Hospitalization - statistics & numerical data; Humans; Male; Medication Therapy Management - organization & administration; Methods; Middle Aged; Patient-Centered Care - organization & administration; Pharmaceutical Services - organization & administration; Pharmacists; Pharmacists - organization & administration; Practice; Primary Health Care - organization & administration; Retrospective Studies
• ISSN: 1079-2082; 1535-2900
• DOI: 10.2146/ajhp140487

PURPOSEThe impact of a clinical pharmacist-led medication management program (MMP) within a patient-centered medical home (PCMH) was evaluated. METHODSThis retrospective analysis included patients in Sutter Healthʼs electronic health records who (1) were seen by the MMP clinical pharmacist within the PCMH (MMP cohort), (2) were within the PCMH but were not referred to the MMP pharmacist (PCMH cohort), or (3) received usual care at two non-PCMH primary care clinics (usual care cohort). Patients were matched on their propensity for receiving medication management. The primary outcome measure was healthcare resource use (i.e., ambulatory care visits, emergency department [ED] visits, and hospitalizations). RESULTSMMP patients had a higher percentage of ambulatory care visits relative to PCMH patients (p = 0.004) but a lower rate of hospitalizations (p = 0.003). The MMP group had a lower frequency of hospitalizations (p < 0.001) and ED visits (p = 0.014) relative to patients in the usual care group. No differences in healthcare resource use were observed between the PCMH and usual care cohorts. Glycosylated hemoglobin, blood pressure, or low-density-lipoprotein cholesterol at goal did not significantly differ among the three cohorts. CONCLUSIONPatients in a pharmacist-led MMP had a significantly higher estimated rate of ambulatory care visits but a lower rate of hospitalizations than did patients who attended the same clinic but were not in the MMP. MMP patients had a similar rate of ambulatory care visits but significantly lower rates of hospitalizations and ED visits than patients receiving usual care.